Policy

As we think about the theme of this issue -- “Social Innovations in Community Civic Engagement: Parents as Consumers of Education?” -- we might do well to start with several questions:

Why do educators need to be engaged with parents?

From their perspective, why should parents want to be engaged with you? What do they want from being engaged?

Spend a minute or two to reflect on these questions. Then, perhaps jot down your responses.

As experts, either through formal (e.g., professional) expertise, or through personal (lived) expertise, we almost always have normal, knee jerk answers to the questions proposed, let’s rethink those answers.

Let’s start by rethinking what we mean by engagement (either civic or community), as well as how that rethinking may lead us to the steps we need to take to bridge what Daniel Yankelovich calls “the expert-public gap.”

The Metaphors of Engagement1

The term “engagement,” whether “civic” or “community,” or any of a number of other possible modifiers, is a metaphor that brings different images to different people’s minds. When I’ve asked people what image comes to mind when I say the word “engagement,” I get three different kinds of answers:

There are responses that bring to mind what I would call rules of engagement, a phrase that conjures up images of the military, or the 2000 movie with that title. Rules of engagement are essentially rules that govern the conditions under which -- times, places, and ways -- soldiers may come into contact with the other side, the enemy. They are designed to maximize one’s control over the situation, one’s own safety and, if necessary, inflict the greatest damage on the other.

There are responses that bring to mind the image of gears engaging -- two or more objects coming together as part of a larger mechanism. When those objects come together correctly, the mechanism works well. When they don’t, there’s a terrible grinding experience.

The final set of responses this term brings to mind, is of images of people getting engaged to be married -- what I’ve come to call “reciprocal engagement.” In reciprocal engagement people come together with a sense of reciprocity -- of giving and getting, of both teaching the other, learning from, and learning with the other. In reciprocal engagement all parties are engaged with others in ways that brings the others in as collaborators or co-constructors.

The Expert-Public Gap2

Daniel Yankelovich, once referred to as the “Dean of public opinion polling” and co-founder with Cyrus Vance of the Public Agenda Foundation,3 has argued that there is typically a gap between the public and formal experts in any field. This gap is created because experts tend to view the world through the lenses of their area(s) of expertise -- education, economics, public policy, technology, etc. -- while the public tends to look at the world through the lenses of daily experience. This leads to three kinds of differences between the ways experts and the public view the world, which I will briefly illustrate using education as a focus:

Different points of departure:When thinking about curriculum, school leaders tend to focus on grade-level curriculum or on how students will move through the curriculum from year to year. Parents, on the other hand, tend to concentrate on what their child needs now or is learning at any given moment.

Different/confusing uses of language:When talking about curriculum, and sometimes when talking about how students are progressing from grade to grade, educators may talk about scope and sequence, or about scaled scores on standardized tests. At best, such language is opaque to parents, at other times it can alienate parents who really want to talk about whether their child is succeeding or not, or how much progress their child is making, often defined by a teacher-given grade.

Different notions of what counts as a solution:When describing school or grade-level improvements, educators often work to provide programs that serve the needs of most, if not all, children at a given grade level, or who are experiencing different kinds of challenges. Parents, on the other hand, focus on whether the program engages their child(ren) in day-to-day experiences that help their child experience daily success.

These gaps are not insurmountable but closing them requires experts to change their perspective about, and approach to, parents.

Closing the Gap through Reciprocal Engagement

There are three broad reasons to engage with others, each of which is associated with a different metaphor of engagement:

To inform them, or tell them things we want them to know -- most often associated with “rules of engagement;”

To get feedback from them, or hear their response to our directions, suggestions, or requests -- most often associated with mechanistic engagement or gears engaging; and

To build common ground or areas where we can work together so we can all be more effective in achieving individual and shared goals -- most often associated with reciprocal engagement.

It should be clear that reciprocal engagement requires that experts shift their relationship with parents, adjusting their language, eschewing expert terminology in favor of using words and concepts that connect with parents’ experiences. They must also work to understand and connect with the parents “points of departure” -- often, where parents’ concerns come from. At the same time, experts must work to understand what parents believe are acceptable solutions. Doing all of this can help close the expert-public gap.

Engagement as a Platform

One implication of closing the expert-public gap by moving to reciprocal engagement is the notion that such engagement creates something like a social platform in which “consumers” or “customers” and “producers” are interchangeable -- think Lyft or Air BnB.4

In the model proposed by Van Alstyne, et. al., producers create the platform’s offerings, while consumers buy or use the creator’s offerings. In Lyft, for example, someone may be a driver on one day, but a rider of Lyft the next. Or I might stay in an Air BnB offering in one city, while someone else is staying in my house as an Air BnB user at the same time.

While the platform analogy to education is not perfect, talking about reciprocal engagement as creating a kind of platform in education might well be instructive.

The normal, pipeline view is that educators are the producers and that students go through the pipeline and come out a finished product (e.g., with a diploma). Students, or perhaps their parents, consume the service provided by the educators. Engagement between producers and consumers is either on the “rules of engagement” or “gears engaging” model.

If we think about shifting to a “reciprocal engagement model” we ask how and what educators, students, and teachers can give and get from each other; what they teach to, and learn from with each other. Indeed, great educators at all levels -- pre-K through graduate level -- will often say they learn as much from their students as they believe their students learn from them. And one of the premises of having students, parents, and educators together at meetings to develop and assess progress on Individual Education Plans (IEPs) is that each actor has lots to learn from the others. Together, they collaborate on, and co-construct, not only the student’s learning plan, but the instructional plan of the educators, as well as co-construct the way the parent-student-teacher relationship will evolve to support those plans.

The Pottstown School District Example

We see this emerging in the Pottstown Early Action for Kindergarten Readiness (PEAK) program in the Pottstown School District and community. Over the last three years, we have been working with them to create opportunities for reciprocal engagement among teachers and those parents/families who have been least engaged with district/community education programs. As part of this work, we’ve worked with the district to create a “family advisory council” (FAC) composed of interested, but disengaged parents/grandparents. And we’ve worked with the FAC to create “Let’s Talk” forums in which parents come to talk with each other about specific issues -- e.g., bullying, behavior at home and school, homework, social-emotional learning, special education, and more. Each forum starts with a short presentation from the district after which participants break into small groups to talk about what they heard and what that might mean for their behavior and for the way they work with the school district. The FAC develops recommendations for parents and for the school district based on the results of those forums, recommendations which are then discussed, and when appropriate, implemented by the district. In this relationship, it’s difficult to tell who is producer and who consumer, who is the expert and who is a non-expert.

Conclusion

Rethinking what we mean by engagement can lead us to rethink the roles of producer and consumer in education. Focusing on “reciprocal engagement” can, in turn, lead us to think of education as a platform in which the role of consumer and producer can shift among students, parents, and educators so that rather than thinking about buy-in, we think about the ways in which they become partners in co-constructing the educational experience of each.

1 Sokoloff, Harris. “Engaging the Public: How school boards can call for community involvement in important school decisions.” American School Board Journal, September 2001, pp. 26-29.

2 Yankelovich, Daniel. Coming to Public Judgement: Making Democracy Work in a Complex World. Syracuse University Press, 1991, pp. 91-98.

As in the era institutionalization, the current service system providing community-based supports for individuals with intellectual disabilities (ID) has become increasingly self-serving and financially top heavy. Currently, the bulk of the funding despite the current needs-based approach to services, ends up supporting and perpetuating the service delivery system. The support for individuals at a direct needs level appears to have been minimized with the growth of the provider structure. The corporate culture associated with the needs-based community support structure appears to have maintained the control and choices originally meant to go to the individuals and their families. In addition, the services that are provided are unequally distributed based on eligibility standards, level of needs, yearly legislative budgets, and government priority lists.

This article is proposing the need for the development of a knowledgeable, informed citizenry to act as a conflict free and socially inclusive systemic watchdog group. The primary mission of this group would be the redirection and equalization of community supports and services to better service and empower all individuals with ID directly and/or through natural/family and community supports.

One would be hard pressed to find any social credence in a return to the institutionalization of individuals with ID. One would also have difficulty denying the critical impact the role of grassroots parent advocacy movements had over the past 50 years in the success of the depopulation of state run institutions. With this social movement came the eventual establishment of community-based, social, educational, and economic avenues for thousands of individuals providing opportunities from segregation through inclusive lifestyles. One would be naïve in thinking this process could have occurred at all without the major changes in Medicaid funding. Along with this came a major shift as well from program- to needs-based funding. Not only was this the right thing to do, it was at the time the less expensive thing to do.

For eligible individuals, Medicaid changes allowed for the redirection of institutional Medicaid funding from institutionalization to community-based funding (known as Medicaid waiver funding /waiver funding). Over the last 40 years such changes have transformed the lives of thousands across the state allowing them access to live and work in the communities they were born in. Today support service provider agencies provide a defined array of supports and services (known as service definitions). These services include residential supports, day program supports, employment supports, behavior support services, adaptive living supports, as well as numerous other supports.

The depopulation of state institutions brought with it a change from program-funded programs to needs-based funding. Program funding of institutions and the related historical abuse was certainly a catalyst for such a need. The rational for individual needs to determine the funding as opposed to program allotted funding determining the support to an individual had to do with choice and control. The expectation was that if individual needs for services and supports was tied to funding, individuals would be availed more control and choice over the services they received.

Philosophically, the State of Pennsylvania Office of Developmental Programs (ODP) has, and continues to promote the need for individual control and choice through promotion, training, policy, and regulation. This longstanding philosophy developed by ODP is known within ODP as “Everyday Lives.” “The fundamental concept of ‘Everyday Lives’ is that with the support of family and friends, individuals with intellectual and developmental disabilities decide how to live their lives; what supports they need; and how they want to spend the money in their individual budgets. It also means that they are responsible for their decisions and actions.1”

Unfortunately, the corporate culture associated with needs waiver funding continues to allow the domination of choice and control to fall into the hands of Medicaid waiver funded providers.

Over the last 25 years this corporate culture in the community-based services model has resulted in the emergence of a “Medicaid waiver sub culture.” This culture has and continues to segregate and marginalize individuals and families both outside and inside of the Medicaid umbrella in need of supports and services.

Ironically, as in the era of institutionalization, the current service system for individuals with disabilities appears to have become increasingly self-serving and financially top heavy. Further investigation is clearly needed.

In the past, parent groups have successfully advocated for individuals with ID but as time passed these groups have become funded and entangled politically by the service system they initially fought against.

This article is proposing the need for the development of a knowledgeable, informed citizenry to act as a conflict free and socially inclusive systemic watchdog group. The primary mission of this group would be the redirection and equalization of community supports and services to better service and empower all individuals with ID directly and/or through natural/family and community supports.

Services for individuals with ID generally fall into three categories. those not registered at all, those with medical waiver funding, and those without Medicaid funding (known as base funding).

Current estimates are only one-third of all individuals with ID are registered with the current services system. Rational for non-registration is unclear. It has been suggested to appear in some instances as not worth the time given the perceived benefits. Other suggestions appear to be cultural in nature especially within already marginalized populations.

Of those who are registered, there is a wide gap in the services and supports received by individuals who are and who are not receiving Medicaid waiver funding.

To receive any type of substantial or long-term services, Medicaid funding is required. The collective Medicaid waiver funding for individuals who receive Medicaid waiver funding supports the current provider system across the state.

Within the Medicaid waiver funding for services are further gaps in attainable services based on the type of Medicaid waiver one has secured.

Originally, Medicaid waiver funding was based solely on the needs of the individual and generally reserved for individuals coming out of state institutions (known as the consolidated waiver). This consolidated waiver was initially cost effective. In some situations, it allowed for additional funding for additional community placements. Over time this evolved with the emergence of a second waiver with a financial cap of $33,000 (Person/Family Directed Support Waiver) and most recently a third waiver with a $75,000 cap (known as the community waiver). The result of these changes enables limits to be placed on needs-based services and on the type of waiver an individual obtains.

To compound this situation, it appears once an individual does manage to obtain Medicaid waiver services the proportion of funds supporting the provider structure appears to far outweigh the funding of actual direct services provided to the individual (exemplified below).

Registered individuals not receiving Medicaid funding receive county funding that provides minimal and limited services known as “base” funding. Unlike Medicaid funding, services-based funding is limited to case management services and family support services. Generally, these services are limited to less than $1,000 per year for individuals who are approved.

Individuals not receiving Medicaid funding are unable to access the services and supports provided by Medicaid. These services include residential and day services, behavior services, support staff services, and companion and respite services.

Individuals not receiving waiver funding are put on a state-wide priority list to receive waiver funding based on urgency of need.

Over the last 20 years, this waiting list has, and continues to number in the thousands and is subject to yearly funding shortages associated with the Medicaid contract with the state and the willingness of the state legislature to appropriate matching funds.

The result of this structure makes entry into Medicaid funding extremely difficult for anyone who is not in need of immediate emergency services. Many individuals have been waiting years. In addition, those who are on emergency status are subject to competition with others in the same status for services based on their severity of need and the number of available waiver allocations in any county in any given year.

This current funding process appears to have created several gross inequalities on the value of an individual’s needs by putting varied amounts of funding on an individual’s need for services. Some ranging from less than $1,000 per year to others that are as high as $700,000 per year.

A review and contrast of any budgets for individuals with ID readily exemplifies this inequality. For example:

In one instance, an individual is funded by the Medicaid waiver and the provider is receiving $58,000 per year to provide support services for an individual. The direct services to the individual consist of 35 hours of services by a support staffer at $11 an hour with no benefits. In a second situation, a budget of $337,000 is utilized for an individual who lives in a group home.

In a third instance, an individual with ID with a secondary mental health diagnosis is receiving more than half a million dollars in funding per year.

In a fourth instance, an individual has a Medicaid waiver that is capped, thereby forcing the individual in need of both day services and home services to choose between which of the two services they require most.

In the same review, one can easily see the lack of funding availed to an individual who is not receiving Medicaid waiver funding and subject to local limited program-based funding. In one instance, an individual exhausted her yearly allotment to buy a bed.

Systematic Issues Related to Inequality of Services

Other significant and longstanding systemic issues related to the inequality of current supports, services, control, individual choice, and funding include the following:

Ineffective Direct Line Supports

The lack of supports and funding for direct line support staff has been problematic since the beginnings of the movement for individuals from institutions to those in community placement. Compounding this issue appears to be the continuation of the culture of mistrust of the service system and providers for family members as active participants in the direct care of their loved ones.

Lack of Understanding of Current Supports and Services

All one needs to do is talk with a family member or relative with a disability to see the lack of understanding of the current support system by the general public. This appears to continue to be an issue with local and state law enforcement organizations.

A bureaucratic bubble appears to exist that feeds into making those outside of the bubble dependent on someone on the inside to gain any kind of understanding.

In a similar discussion, one would find members of the general public who have no life experiences with individuals with ID generally lacking any knowledge or understanding of the current (or lack of) services and supports available to individuals with ID.

Despite geographical and legal integration into local communities for individuals with disabilities, it appears social integration continues to be a challenge.

Justification for Needs-based Funding Outcomes

The definition of Medicaid waiver services implies the following:

“Consolidated Waiver Home and Community Services are direct services provided to individuals who need assistance in the acquisition, retention, or improvement of skills related to living and working in the community. These services may only be provided through the waivers when the AE (authorizing entity) determines they are necessary to prevent institutionalization.2”

It appears that if services are contingent on skills to live and work in the community, the need for justification of services is needed for individuals to live outside of an institutional setting.

With this said, it would appear to be in a providers’ best financial interest to maintain an individuals’ current need. Alleviating any need for acquiring, retaining, or improving services would jeopardize the possibility of institutionalization, and with it, a need for funding.

Compliance Monitoring and IM4Q

Monitoring of services and supports are problematic in several ways. The first being the time lines associated with county and state monitoring. In these situations, provider agencies are informed in some cases months prior to inspections with ample opportunities for corrective plans. Secondly, monitoring by supports coordinators (case managers) is subject to frequent staff turnover.

Predatory Providers

One of the original intents of the needs-based Medicaid waiver model for the ID population was to foster quality and choice of services and supports. Although further investigation is needed, it appears the lack of oversight and regional scarcity of providers may lend itself to the opportunity for some to make a profit from individuals with disabilities.

Ineffective Supports Coordination

The role of the supports coordinator is to locate, monitor, and coordinates services. These key positions are often filled by well-intentioned, but inexperienced individuals right out of college, and utilized as stepping stones for more lucrative positions within the provider systems. Not unlike an ex-congressman becoming a lobbyist. In addition, the delivery of needs-based services recommended by an individual’s support team is often delayed due to numerous levels of bureaucratic approval between, and within, different provider and government agencies.

Accountable and Conflict Free Incident Management /Abuse Reporting

Current practices allow for a provider to investigate abuse and neglect issues by investigators employed by the provider. In addition, any corrective actions of investigations are also left to the discretion of the provider. Eg., If Joey is hurt by another resident -- unlike you or I -- the police would not be called. The provider would be required to file an incident report, determine if it required investigation, investigate the incidents, and decide on any action needed for correction.

Community and Residential Segregation

Individuals continue to be segregated within the community setting. Advocacy efforts in the past have secured legal pathways for individuals with disabilities. The need for social pathways through community awareness, understanding, and most importantly, participation, remain lacking. It appears that to this end, one critical stakeholder not in support of community inclusion has been the community at large.

Growing Concern Over the Diversity of Service, Economic and Racial

Growing concern appears to be developing over the pathway to eligibility for individuals with ID in obtaining services. The current statewide priority list, and the decisions as to who gets the limited services, appears to lack any type of transparency. There appears to be the impression that individuals who are privy to the structure and/or those with political influence and related family wealth have unequal access to medical funding.

Mental Health

It also appears mental health services for individuals with ID remains problematic. Funding conflicts between Medicaid waiver funding and mental health insurances are often in conflict with each other over payment. At times Individuals with ID are segregated from many current mental health facilities and services. Understanding and services to address the unique needs in recovery for individuals with ID appears lacking in the current mental health system.

Lack of Available Advocacy Services for Adults with ID.

Individual advocacy for individuals receiving services has been on the decrease. Most advocacy organizations that do provide individual services have limited resources and have begun charging for individual assistance. Systemic advocacy appears to be focused mainly on increases in waiver funding. Services for individuals receiving base funding appears to be stagnant. Little if any effort is being made for outreach in identifying individuals who remain outside of the service system.

Innovative Solution and Explain How the Model Works.

Effective watchdog group/grassroots movements have, and continue to be, effective avenues for social change. As noted above, grassroots organizations for individuals with disabilities, such as the ARC, have lead the way in social equality and inclusive living and education for individuals with disabilities.

The need for the development of a knowledgeable, informed citizenry to act as a conflict free and socially inclusive systematic watchdog group is imminent. The primary mission of this group would be the redirection and equalization of community supports and services to better service and empower all individuals with ID directly and/or through natural/family supports.

A shining example of how parent and civic participation can define and change social injustices for the betterment of all was the early educational movement for individuals with ID to obtain the right to education. This early grassroots, parent-driven political movement out of Pennsylvania, now known as the ARC, evolved from a civil rights issue that lead to legal lawsuits. From there the movement addressed federal and state legislation to establish the right to education for all individuals with disabilities, and overtime it caused the depopulation of state institutions for individuals with ID. These effective advocacy organizers found funding through grassroots membership and creative fundraising efforts.

As with most successful social movements the success of their initial cause and advocacy efforts become part of the political landscape. This becomes problematic when advocacy organization membership, participation, and funding is no longer adequate to support efforts.

It appears to many across the state that this has occurred across the disability community, and the need for effective advocacy is currently limited because of the financial marriage between current advocacy organizations and the funding of services for individuals with disabilities. To many it appears the advocacy organizations have become partnered and dependent on Medicaid provider funding.

Initially, these effective advocacy organizations found funding through grassroots membership and creative fundraising. Yet, this does not appear to be the case today, as most are dependent on sister organizations that are funded through Medicaid. In the past, parent groups have successfully advocated for individuals with ID but as time passed they too have become funded and entangled politically by the service system they initially organized to change.

Historically, advocacy organization membership has been targeted toward middle class white communities with leadership roles targeted toward upper middle-class whites. Although this was effective in the past, such segregation over time would make one question the need for a more comprehensive approach to advocacy that is more economically and socially representational.

As noted, this article is proposing a renewed movement of conflict free advocacy to support and safeguard the control and empowerment of choice for individuals with ID and their families. This movement would not be unfamiliar to those of yesterday but would include several additions and new dynamics.

A membership based and funded organization comprised of families and direct care givers (paid and unpaid) could be organized as a nonprofit, free of funding obligations with the current provider system.

The membership might consist of a cross-population of individuals who have interaction and contact with individuals with ID daily. These members might include direct and extended family members, friends of family members, neighbors, local community businesses, political leaders, and individuals providing direct support.

One ideal situation might be a partnership with a for profit or a philanthropic organization. This might alleviate any tendencies over time for any future financial conflicts of interest or buy-ins.

Memberships could be targeted to include all levels of social and economic classes and cultural diversity. The advancement of technology in the past several decades made this a lot more feasible than in the past and it has been successfully utilized by other organizations to promote causes and to get out the message.

Members could be solicited for input on their knowledge, needs, attitudes, experiences, and suggestions on how to better serve and support inclusive communities for individuals with ID. The members and leadership could promote legislation to support all individuals with disabilities without subjection and dependence on the political tide of the annual funding of Medicaid contracts and funding limitations. The leadership could research and publish best practices and monitor current services. They could provide individual and systemic advocacy for individuals with ID. The members and its leadership might act as consultants on policy and regulatory changes to alleviate systemic/bureaucratic barriers to better enhance individual control and choices of supports and services.

In addition, the organizations’ members and leaders could monitor current services and supports based on its membership’s experiences and compare this information with the values of the “Everyday Lives” model (aforementioned). Membership could foster advocacy for family/parent groups, not unlike those effectively used on a local level, in the improvement of educational services and the promotion of a more positive culture in local school districts.

The model would include promotion of the following:

The Case for Civic and Community Engagement

Civic engagement and participation has and continues to be a powerful force in creating and maintaining positive social changes within a society. Throughout our history, grassroots and populous movements have over time opened doors for many who had been marginalized. In a capitalistic environment the success of such movements to maintain a balance for social needs over economic progress remains a challenge.

Effective watchdog groups/grassroots movements continue to be effective avenues for social change. As noted above, grassroots organizations for individuals with disabilities, such as the ARC, have lead the way in social equality and inclusive living and education for individuals with disabilities. As with most successful social movements the success of their initial causes and advocacy efforts become part of the political landscape.

Within the context of this article we are calling for a renewed movement directed towards a wider community-based and diverse membership whose active involvement might address needs not currently being met or addressed given the current corporate environment of the services system.

These include:

The need for transparency;

Redistribution and redirection of funds;

Establish level of community standards;

Diversity of services;

Eradicate bureaucratic and regulatory segregation;

Development of community awareness at a local level through education and public promotion campaigns;

Wider political base that includes members of the community who are aware of and knowledgeable of both the individuals’ and community needs associated with the advancement of true inclusion;

Further development of, and public acceptance and understanding of, the needs and benefits of inclusive communities for individuals with and without disabilities; and

Support, expansion, and simplification of access to funding to enable individuals to manage their own services and supports.

The end result of the infusion of community and civic groups as stakeholders committed to truly inclusive communities can continue to lead to an integration of services and supports within the community at large.

Throughout history grassroots populous movement have, and will continue to be, critical elements in the challenges of social change. The segregation and ultimate inclusion of individuals with disabilities into our society continues to be challenged despite significant legal protections and awareness. Segregation has and will continue to lead to inequalities in services and supports. Only with the empowerment of individuals with ID, and support to safeguard the ability to maintain control and freedom of choice in their daily existence, can the vision of an” everyday life” become a reality3.

EXECUTIVE SUMMARY

The purpose of this study is to provide additional context to publicly available estimates of state and national compensation for persons working as Direct Support Professionals (DSPs). Commissioned by three Pennsylvania associations The Alliance of Community Service Providers (The Alliance CSP), PAR (Pennsylvania Advocacy and Resources for Autism and Intellectual Disability), and Rehabilitation and Community Providers Association (RCPA), this report will largely focus on individuals working as DSPs in Pennsylvania. Specifically, this study will outline:

The relationship between increasing DSP wages and service quality improvement,

The cost benefit to the Commonwealth when increasing DSP wages, and

The positive impact on the DSP quality of life by increasing DSP wages.

The study concludes that current wages require DSPs to rely on public assistance creating increased demand on the Commonwealth of Pennsylvania’s budget. In addition, current wages cause DSPs to leave their jobs at an alarming rate (11.9 percent vacancy rate and 26 percent staff turnover), thus compromising the quality of care to Pennsylvania’s most vulnerable individuals: children; persons with intellectual disability or autism; and persons with drug and alcohol addiction.

While the study answers several important questions about DSPs, further research is warranted in the following areas:

A wage study to determine the extent that increased wages reduce vacancy and attrition rates and inclusion of an analysis of the impact on managers and supervisors that currently make only marginally more than the current DSP wage.

A study on the economic impact on Pennsylvania, namely to determine the percentage of dollars spent through increased wages which are returned to taxpayers through additional tax revenues.

A study that assesses the impact on service quality to DSP compensation practices.

A study to determine the economic impact on the local economy when raising DSP wages.

DIRECT SUPPORT PROFESSIONAL COMPENSATION PRACTICES

Direct Support Professional (DSPs) are individuals who receive monetary compensation to “provide a wide range of supportive services to individuals with intellectual and developmental disabilities on a day to day basis, including habilitation, health needs, personal care and hygiene, employment, transportation, recreation, and housekeeping and other home management related supports and services so that these individuals can live and work in their communities.” i This workforce may also be known as Client Care Workers, Residential Counselors, or Personal Care Aides, and they provide critical support to ensure that individuals who have intellectual disability, autism, and/or behavioral health concerns can “lead self-­‐directed, community and social lives.”ii

In June 2003,iii per the US Department of Health & Human Services, there were 874,000 Full Time Equivalent (FTE) DSPs assisting individuals with intellectual disability, autism and/or behavioral health concerns in various settings. DSPs provide care and support to over one million Americans in need of these life-span services and supports. By 2020, it is estimated that the demand for DSPs will grow to 1.2 million due to increased life expectancy of individuals who require services; aging of the baby boomers; increased prevalence of intellectual and/or developmental disabilities; and expansion of community support systems. This constitutes a 40 percent increase in the demand of services in a little more than 17 years. With 2020 just three years away, one must speculate that the 874,000 figure substantially underestimates the current demand for services and supports.

Compensation for DSPs has long been an issue of concern,iv with numerous salary surveys conducted over the past 40 years. Some studies focused on the distinction between private community and public congregate care settings (i.e. state centers), while others made no such distinctions. The primary collectors of this data have been researchers associated with the University of Minnesota. The below figure represents a summary of the DSP wage data and trends from 1979 to 2015 in both private and state settings.

The main factor that stands out from this figure is that DSPs working for private providers in the community tend to make roughly two-thirds of the wages of similarly employed individuals who work for the state.

More recent studies reveal a continuing pattern of low pay being associated with the DSP position. The 2014 Minnesota studyv reported a mean hourly wage of $11.26 for private DSPs, while a systematic replicationvi conducted in Pennsylvaniavii reported a mean hourly wage of $11.26 in 2014. More current Pennsylvania dataviii revealed a modest increase to a median of $11.50 per hour for DSPs. This trend is confirmed by the Bureau of Labor Statisticsix as seen in the chart below, where 73,630 DSPs in Pennsylvania make a slightly higher annual mean wage than the national average, at $22,160.

To break down the DSP workforce by type of service (e.g., intellectual disability, mental health, autism, and drug and alcohol) we pulled data from job listings and recruitment sites. According to Glassdoor,x a job listing and recruiting website, salaries for DSPs align with the aforementioned references. The hourly wages as shown in the chart below ranged from $9.39 to $12.01 per hour. DSP positions are listed at $9.39 per hour for the mental health field, $10.04 per hour for the intellectual disability field, and $11.47 for the autism field. A DSP position for drug and alcohol rehabilitation was listed at $10.35 per hour, while a DSP position for child care was listed at $12.01 per hour. These wages are consistent with national data.

WHAT IS THE FAIR COMPENSATION PRACTICE FOR DSPS IN PENNSYLVANIA?

One might argue that the proper price for a DSP is the price for which people are willing to work. This is the basic Economics 101 argument, and it would pertain if Pennsylvania providers could hire enough appropriately trained staff to work as DSPs. However, given the current 11.9 percent vacancy ratexi, it is clear providers are unable to hire enough DSPs. There is also a significant concern that DSPs are not adequately prepared.xii Implied is the suggestion that even with relaxed expectations for DSPs, the field is unable to fill all vacant positions. Combined with the aforementioned rapidly growing demand for DSPs, by 2020, we are positioned to experience a latent crisis.

A variety of demographic trends have united to result in an increased demand for DSPs in the immediate future. Given the challenges currently being faced in the recruitment and retention of DSPs, the projected increase in demand can only result in the forecast of a potential catastrophe with providers being unable to hire the appropriate number of DSPs to support the needs of individuals who have intellectual disability, autism, and/or behavioral health concerns. It appears unlikely that providers will be able to manage the 26 percent turnover rate; fill the current 11.9 percent vacancy rate; or meet the increased demand for DSPs with the current government-suppressed wages.

Numerous studiesxii have examined factors related to Direct Support Professional turnover. Wages remain the most consistent and impactful predictor of turnover. With high vacancy rates and high turnover rates, employers become less selective, and staff quality declines. Furthermore, if higher standards were required, it could reasonably be anticipated that the vacancy rate would increase further.

These concerns extend well beyond the mere ability to fill vacant positions. The inability to fill DSP positions directly affects the quality of life for the persons supported by DSPs. The constant turnover of staff results in a transitory quality in regard to the knowledge held about consumers, as well as consumers themselves losing contact with trusted and relied-upon staff. Both turnover and staff vacancies affect the quality of care by disrupting social support networks, jeopardizing program continuity, and, ultimately, increasing the costs of providing services. The high turnover and vacancy rates require providers to offer overtime to existing DSPs to meet the needs of consumers which increases provider costs. The stress and strain on DSPs, due to working overtime hours and serving a challenging population, poses risks to consumers and overall lowers service quality. This risk has been detailed in overtime work within the nursing population.xiii

When comparing fair compensation practices to the related profession of Nursing Assistants, we note that there is current legislation in Pennsylvania, the “Nursing Home Accountability Act” (House Bill 192 and Senate Bill 1057 (Appendix A), that is based upon the Nursing Home Jobs That Pay Studyxiii that argues for “an increase of the average wage for nursing assistants to $15 per hour to meet a living sufficiency standard for an employee with one child to provide for themselves and the child without the need for public assistance.” Studies on the cross-section of public benefits and low-income workersxiv argue that wages need to rise to $19-22 per hour for individuals to no longer need to rely on public benefits, while many DSPs would need to earn as high as $32 per hour to cover expenses related to making up the difference for lost benefits.xv

When taking the above data and trends into consideration, we conclude that DSPs, at a minimum, need to receive equal compensation to Nursing Assistants as they provide a similar level of care. In addition, this would level the playing field since providers of intellectual disability and autism supports/services and providers of nursing home services are competing for the same candidates for potential employees.

When taking into consideration the reality that a large portion of the 34,000 DSP workers in our study work overtime or rely upon public subsidies to make ends meet, a fair wage for a DSP should be at least $18 per hour, which would increase their projected annual earnings from $24,752 to $37,440. A DSP wage of $18 per hour still falls below the living wage recommendations,1 but it would improve service quality by reducing turnover rates, decreasing vacancy rates, and reducing current overtime practices which result in overworked DSPs, and reducing reliance on public assistance.

1 According to a study from the Alliance for a Just Society, a living wage for a single adult in Pennsylvania would be $16.41 per hour. A single adult with a school-age child should make $24.35 per hour, with two children, that increases to $31.67 per hour.

PUBLIC BENEFIT ENTITLEMENTS TO SUPPLEMENT DSP SALARIES

Nationally, low wages cost taxpayers $152.8 Billion annually in costs related to supporting working families with public benefits, per a 2015 studyxvi from the UC Berkeley Labor Center. The study states:

“Stagnating wages and decreased benefits are a problem not only for low-­‐wage workers who increasingly cannot make ends meet, but also for the federal government as well as the 50 state governments that finance the public assistance programs many of these workers and their families turn to. Nearly three-­‐quarters (73 percent) of enrollees in America’s major public support programs are members of working families; the taxpayers bear a significant portion of the hidden costs of low-­‐wage work in America.”

Working families with young children, especially single parent families, are more likely to receive multiple public benefits. This family type is more likely to be low-­‐income. Because of this, many public subsidy programs target outreach to help them secure benefits. Public support helps many single parent families meet basic needs.xvii However, navigating eligibility requirements can be difficult. The process is likened to that of a Rubix Cube, wherein the various pieces of the puzzle are difficult to line up. Income eligibility levels differ for each type of public support, programs count different forms of income to determine eligibility, while still other programs allow recipients to deduct basic needs from their income creating further ambiguity.

Organizations such as Benefits Data Trust have developed sophisticated algorithms and computer programs to navigate the public benefits maze. Benefits Data Trust has developed a chart (Appendix B) that serves as a guideline rubric for benefit qualifications. The chart summarizes 16 benefit programs for which an individual would qualify based on age, income, assets, and family size. Benefit qualifications, payouts, and scheduled disbursements differ in each of these benefit programs, and the size of the benefit payout differs for each benefit based on the requisite qualifications listed. Other organizations such as Single Stop USA and Benefits Kitchen have also developed software to align individual scenarios to public benefit qualifications. The complexity of obtaining these benefits is an obvious deterrent for the persons and families who might potentially benefit from these programs, such as the average low-­‐wage DSP worker.

To provide perspectivexviii, based on the national average, an individual working 40 hours per week and making below $12.16 an hour (or $25,293 annually) would qualify for an average of $1,917 in Earned Income Tax Credit (EITC); $1,078 in Child Tax Credit (CTC); $295 in Low-­‐Income Home Energy Assistance Program (LIHEAP); $3,162 in Supplemental Nutrition Assistance Program (SNAP); $3,308 in Housing Assistance, $2,201 in Temporary Assistance for Needy Families (TANF); and $712 in Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). If all benefits were obtained, the average DSP would qualify for $12,673 in public benefits, excluding Medicaid.

To better understand how wages are correlated with public benefits, below are three scenarios of a DSP worker in PA earning $11.50 per hour; a single DSP worker in PA with one dependent earning $11.50 per hour; and a single DSP worker in PA with two dependents earning $11.50 per hour.

Our reliance on illustrative scenarios is the unfortunate product of the complexities of public benefits qualifications and data that does not exist (i.e. valid estimates of the family compositions of the Pennsylvania DSP workforce and numbers of DSPs who receive public benefits by type). The savings on public benefits requires additional data on Pennsylvania DSPs’ access to benefits. Rather than offer an estimate of likely benefits based on guesswork, a scenario based approached was adopted. Admittedly, this is less than ideal, but it emerged as the only reasonable compromise.

WHAT IS THE CORRELATION BETWEEN INCREASED WAGES AND PUBLIC BENEFIT SUBSIDIES?

Based upon the 2016 study from the Economic Policy Institute (EPI),xvii raising wages for all workers making below $12.16 an hour will reduce taxpayer spending on public benefits. Raising wages to $18 per hour does not guarantee that all public benefits will be eliminated. However, it does move many DSPs along the continuum to being self-sufficient and not needing public subsidies. In addition, it saves taxpayer dollars. The Economic Policy Institute demonstrated that for every one dollar increase in hourly wages for the roughly 27.5 million workers earning up to $12.16 an hour, the share relying on public assistance is predicted to decline by 3.1 percent.

What is important in the Pennsylvania context is that many DSPs in Pennsylvania currently work overtime due to low wages and depend upon this additional income to meet basic living requirements. For many of these DSPs, by working overtime hours, they eliminate their eligibility for public benefit subsidies. This requires most DSPs to make an unfortunate trade-off: either accept public benefits, or work significant overtime to make ends meet.

WHAT HAPPENS IF DSP WAGES ARE INCREASED TO $18 PER HOUR?

Impact on Consumers: High turnover negatively impacts the quality of service delivery. Employees are the most critical input to achieving high-performance outcomes.xx Reducing turnover translates into increased program continuity and an enhanced ability to provide ongoing support to each individual consumer. With a significantly higher pay rate, providers would attract more capable staff that would provide consumers with a higher quality of care. It would reduce competition with other businesses like fast food chains for employees with the most potential. Providers would become an employer of choice, much as the state developmental centers have been employers of choice for years.

Impact on DSP Employees and their families: Referencing Pennsylvania dataxxi the typical DSP at $18 per hour would now earn $37,440 annually, and even with reducing overtime by 60 percent to 206 hours for a DSP each year, many DSPs could still earn an additional $5,572 per year ($43,012 total per year). In all likelihood, DSPs would lose access to and not need most forms of public benefits with an increase in their hourly wages. They would be able to work fewer hours and be more financially capable of supporting their children in achieving educational goals.

The literature has documented that an individual that had to either work overtime or subsist on public benefits due to low wages has been proven to experience diminished health, increased obesity, and hypertension.xxv This low-wage environment has a striking human cost. It minimizes the ability of parents to fully participate in their children’s development, and children of low-wage parents are often forced into the labor market early. Children of low-wage parents are more likely to face educational difficulties, and “trade-offs between spending time with children and earning an adequate wage can trap parents in familial hardship.” Finally, children of low-wage earning parents are more at risk for health problems and complications.xxvi

Impact on Tax Payers: The literature suggests that vacancies and overtime are surprisingly linked to wages. Low wages, even within the context of the relatively narrow range of hourly wages, correlate to higher rates of vacancy and turnover. A reasonable hypothesis would be that higher pay might reduce turnover. We note that higher pay to employees of state centers has been associated with positive outcomes such as lower rates of turnover (Price, 2015), with Ohio Civil Service Employee Association president Christopher Mabe reporting state center turnover rates as low as 10 percent. A similar news report (Hult, 2017) cited a reduction in staff turnover in a mental hospital following a pay increase.

A reasonable question then becomes to what extent turnover and vacancies might decline in the event of an increase in DSP compensation in Pennsylvania. Once again, strong data on this issue is unavailable. The Hult study mentioned the above referenced 60 percent decrease in turnover in a state mental hospital. We have elected to follow the Hult study conclusion of a 60 percent decrease in turnover if wages increase to $18 per hour. Given this conclusion, below are the costs and benefits to taxpayers.

Considering the two scenarios of raising DSP wages to $15 and $18 per hour respectively, increasing DSP wages to $15 per hour would cost taxpayers $237 million ($7,275,000 would be returned in income tax payments), but would ultimately result in taxpayer savings of $199 million. Increasing wages to $18 per hour would initially cost taxpayers $467 million annually which would be reduced to $41 million once taxpayer savings were accounted for. This equation does not consider the $934 million that would be injected into the Pennsylvania economy in the form of higher wages for workers resulting in additional state and local tax revenues.

POLICY RECOMMENDATIONS

Immediately increase wages for DSP workers to $15 per hour and eventually to $18 per hour from the current median of $11.50. These increases initially require additional funding, but will result in long-term and substantial taxpayer cost savings and are vital to avoid the growing DSP employment crisis driven by the 26 percent annual turnover rate; 11.9 percent vacancy rate; and a projected increased demand for DSPs due to increased life expectancy of individuals requiring services; aging of the baby boomers; increased prevalence of intellectual and/or developmental disabilities and behavioral health concerns; and expansion of community support systems.

Fund a pilot study for one to two percent of the DSP population (an estimated 736 – 1,472 individuals) that will determine the benefits of increasing the DSP base hourly wage of $18 per hour for each directly employed or subcontracted employee of an agency hiring DSPs.

CONCLUSION

Pennsylvania public officials, in order to address the DSP workforce crisis (26 percent turnover rate; a 11.9 percent vacancy rate; and a projected increased demand for DSPs) and substandard care for Pennsylvania’s most vulnerable, need to enact a transparent rate setting process that will provide adequate wages for DSPs that eliminate the need for public assistance and will provide them with the dignity they deserve. We recommend an immediate increase in wages for DSP workers to $15 per hour with a scheduled increase to $18 per hour from the current median hourly wage of $11.50.

ACKNOWLEDGEMENTS

Special Thanks to Benefits Data Trust who provided the public benefits chart and the benefit access scenarios. Benefits Data Trust assists tens of thousands of people with government programs using private sector strategies.

AUTHORS

Michael Clark, M.P.A., is the Executive Director of Impact Germantown. He is a systems entrepreneur based in Philadelphia, Pennsylvania. He has researched, published, and worked in the areas of collective impact, financial innovation, impact investing and social entrepreneurship. Mike is the lead researcher and policy analyst regarding the social impacts of paying direct service workers low wages forcing them to be dependents upon society through public benefits and reducing the quality of care due to high staff attrition and increased stress levels. Mike also served as a Peace Corps volunteer in Bulgaria. He holds a Bachelor’s degree from the University of Scranton, and a Master of Public Administration from the University of Pennsylvania’s Fels Institute of Government.

Scott Spreat, Ed.D. is the President of Woods Research and Evaulation Institute at Woods Services. He has been a member of the Woods team since joining in 1992 as the Administrator of Clinical Services. He was responsible for designing, opening and running the Woodlands program and served as its Executive Director before being promoted to Vice President for Behavioral Health in 2005. In recent years, Dr. Spreat has been the key liaison with Harrisburg legislators and lobbyists and serves on the board of PAR (Pennsylvania Advocacy and Resources for Autism and Intellectual Disability). He was a member of the American Association on Intellectual and Developmental Disability’s Terminology and Classification Task Force and served in the work group that developed the definition of Intellectual Disability. Dr. Spreat received his doctorate in Educational Psychology and is a licensed psychologist who worked for Temple University’s Woodhaven Center, conducting research, directing the clinical services department, and serving as the Executive Director of the 284-bed program before coming to Woods.

Nicholas D. Torres M.Ed. has over 20 years of experience in executive management. He built and led one of the largest and nationally recognized human services organizations; founded/governed/led two charter schools and a nonprofit dedicated in scaling high-impact social enterprises (e.g., school based health centers; college access and completion pipelines; and early literacy technology platform); founded and currently leads a social sector “think-tank” organization; and teaches at UPENN Fels Institute of Policy and the Wharton School. From 2000 – 2010 Nicholas served as President of Congreso de Latinos Unidos. Under his leadership, Congreso was one of just six national leadership investments ($5 million) from Edna McConnell Clark Foundation to demonstrate multi-service organization impact on young people aged 16-24. As a result of this investment, he created a first-of-its-kind performance management system to measure organizational effectiveness for over 50 service lines and 17,000 clients/customers that would later be used as a model for Social Solutions’ Efforts To Outcome (ETO) to scale in nonprofits nationally. He then served as a member of the National Alliance for Effective Social Investments that led the nation on integrating Social Impact Indicators into nonprofit best practices. Currently, Mr. Torres serves as CEO/Co-Founder of Social Innovations Partners that manages the Social Innovation Journal; Institute; and Lab and teaches Policy; Leading Non Profits; and Social Enterprise at the University of Pennsylvania. He has co-authored several books and serves on many regional and national. Mr. Torres received his BA from Carleton College and his Master's in Educational Psychology from the University of Texas at Austin.

APPENDIX A: HOUSE BILL 1449 AND SENATE BILL 1057

“Nursing facilities are predominately taxpayer-funded through reimbursements from the medical assistance program and Medicare program”[9] and that “Taxpayers should not subsidize nursing facilities to reap profits while many of their employees are living in poverty.”[10]

The Pennsylvania Department of Labor and Industry reports, “the average wage for nurse assistants is $13.39 and the average wage for dietary and housekeeping employees is $9.81.”[11] PathWays PA, a not-for profit Pennsylvania organization that provides services and advocacy for women, children, and families,[12] finds, “a wage of $15 per hour would meet the sufficiency standard for many, but not all, counties of this Commonwealth for an employee with one child to provide for the employee and child without the need for public assistance.”[13]

The Bill also states, “A worker who faces low wages or part-time work, or both, is too often eligible for taxpayer-funded medical assistance instead of affordable, employer-based coverage. Controlling health care costs can be more readily achieved if a greater share of working people and their families have health benefits so that cost shifting is minimized.”[14]

Accordingly, the proposed Nursing Home Accountability Act has four purposes:

(1) Create a living wage certification program for each nursing facility that provides a base hourly wage of $15 per hour for each directly employed or subcontracted employee of the nursing facility.

(2) Encourage the provision of a living wage to each nursing facility employee by providing information to each nursing facility resident and the public on the wage rate paid to the employees of the nursing facility.

(3) Ensure that each nursing facility pay a nursing facility employer responsibility penalty for health coverage received by each employee of the nursing facility through the medical assistance program and another public assistance program that is fully or partially funded with funds from the Commonwealth, with that penalty based on the costs incurred by the Commonwealth for providing these benefits to the employee of the nursing facility.

(4) Ensure that each nursing facility employee who receives public assistance is protected from possible retaliation by the nursing facility for seeking or obtaining that assistance.[15]

There are two key components of the legislation:

A Nursing Facility Living Wage Certification program “requires each facility participating in the Medicaid program to report” information,[16] in a verifiable and auditable form,[17] about the minimum base hourly wage paid for each job classification and the number of employees in each classification. The Department of Public Health will give a “living wage certification” to each facility whose wages meet the living wage certification standard,[18] which is defined as $15 as a base hourly wage, adjusted annually.[19]

A Nursing Facility Employer Responsibility Penalty imposes a penalty on each facility whose employees are receiving public assistance, with the amount of the penalty based on the “actual cost of providing public assistance to each covered employee for the most recent fiscal year.”[20] The Bill authorizes limited administrative appeals: facilities may “only challenge whether the Department correctly determined the number of covered employees that are the subject of the penalty.”[21] The Department of Human Services may deduct any unpaid penalty and interest from Medicaid payments that are otherwise due the facility[22] and the Department of Health may refuse to renew the license of a facility that has not paid the penalties and interest or agreed with the Department on a plan of installment payments.[23] The Bill provides for interest payments;[24] prohibits practices that designate employees as independent contractors, prohibit employees from enrolling in public assistance, or discriminate against employees enrolled in public assistance;[25] and provides for employee remedies.[26]

APPENDIX B: PUBLIC BENEFITS CHART

References

i Hewitt, A., & Larson, S. (2007). The direct support workforce in community supports to individuals with developmental disabilities: Issues, implications, and promising practices. Mental Retardation and Developmental Disabilities Research Reviews, 13, 178-187.

iii US Department of Health & Human Services. (2006). The supply of direct support professionals serving individuals with intellectual disabilities and other developmental disabilities: Report to Congress. Washington, DC: US Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation.

xiv Kasperkevic, J. (2014). The benefits cliff: When minimum wage increase backfires on the people in need. Link.

xv Albeida, R. * Carr, M. (2016). Between a rock and a hard place: A closer look at cliff effects in Massachusetts. UMASS Boston Center for Social Policy. Link.

xvi Jacobs, K., Perry, I., & MacGillvary, J. (2015). The High Public Cost of Low Wages. Poverty Level Wages Cost US Taxpayers $125.8 Billion Each Year in Public Support for Working Families. UC Berkeley labor Center. Link.

xvii Albeida, R. * Carr, M. (2016). Between a rock and a hard place: A closer look at cliff effects in Massachusetts. UMASS Boston Center for Social Policy. Link.

xviii Cooper, D. (2016). Balancing paychecks and public assistance. How higher wages would strengthen what government can do. Economic Policy Institute. Link

Introduction

As cities across the country experience growth in their immigrant populations, the New York City Mayor’s Office of Immigrant Affairs shows every day that engaging in meaningful partnerships with immigrant communities, advocates, nonprofit, private sector, and philanthropic leaders, is key to our success as a city. This collaboration strengthens our ability to create innovative programming that advances immigrant inclusion, promotes access to justice, and advocates for positive reforms for immigrant communities at the national level. We envision a city in which immigrant families thrive, being an immigrant is an asset, immigrants are able to access and participate in civic life, and immigrant communities are empowered and informed about their rights, available services, and opportunities. As part of this mission, we must ensure City agencies and policymakers systematically integrate immigrant inclusion in their work, and engage a range of communities at all levels of government. This article shares our experiences and best practices in an effort to accomplish these goals, through robust partnerships with key stakeholders in the field.

New York’s Immigrant Experience

New York City has a long history as a city of immigrants. Since the city’s early days, New York has been a top destination for immigrants. Today, nearly 38 percent of New Yorkers are foreign-born, the highest level in a century (NYC Department of City Planning n.d.; NYC Department of City Planning 2017). At 3.2 million people, if New York City’s immigrant population were a city on its own, it would be the second largest city in the country -- only trailing NYC itself. These numbers increase substantially when factoring in the children of immigrants; together, immigrants and their children constitute approximately 60 percent of NYC’s population (American Community Survey 2015). Immigrant New Yorkers contribute greatly to the city’s cultural and civic life, with many immigrants and their children taking prominent roles in the arts, the restaurant and tech industries, and politics, among others. Immigrants contribute substantially to the city’s economy, earning one hundred billion dollars a year (about one-third of total earned income in New York City), owning 51 percent of small businesses, and accounting for roughly half of workers in core sectors of our economy like technology, financial analysis, entertainment, and medical (NYC Comptroller 2017). The benefits of steady immigration to New York City over the last half century in the areas of civics, culture, and the economy are mirrored across the country, and highlight the importance of working with and supporting immigrants as integral members of our communities.

For decades, recognizing and celebrating the value of immigrant New Yorkers has been a priority for local government across mayoral administrations. Former Mayor Ed Koch first created the New York City Mayor’s Office of Immigrant Affairs in 1984. At that time, the Office of Immigrant Affairs was a branch under the Department of City Planning. Former mayors David Dinkins and Rudy Giuliani, both elevated the office to further prominence during their administrations. In 2001, the city’s voters approved a referendum establishing the Mayor’s Office of Immigrant Affairs as part of the city’s Charter, safeguarding the rights of immigrants to City services as the city’s legal responsibility. The following year, Mayor Bloomberg appointed the Mayor’s Office of Immigrant Affairs’ first commissioner. Under Mayor de Blasio’s leadership, the Mayor’s Office of Immigrant Affairs has considerably expanded its programming and staff to more meaningfully integrate the voices and experiences of immigrants into City government.

Immigrant Inclusion

Given the central role that immigrant communities play in the vibrancy of the city, it is critically important to integrate their voices and experiences in City government, including in policymaking and program development. Through our trailblazing work with the IDNYC program, language access and immigrant workers’ rights, the Mayor’s Office of Immigrant Affairs has reified our commitment to make New York City even more inclusive.

IDNYC

New York City’s landmark municipal identification card program, IDNYC, is a prime example of how the public, nonprofit, and private sectors can come together to respond to the needs of immigrant communities. IDNYC was developed to meet the gap of residents who did not have government-issued identification, including immigrants, homeless individuals, seniors, survivors of domestic violence, and transgender and gender non-conforming residents. Until recently, many New Yorkers lacked government-issued IDs and many immigrant New Yorkers faced a heightened challenge in obtaining IDs, as undocumented immigrants generally cannot apply for driver’s licenses in the State of New York. For years, activists and organizers pushed for the creation of a municipal ID program, and during his first campaign for mayor, then-candidate Bill de Blasio vowed to sign a bill enacting a municipal ID. In July 2015, Mayor de Blasio delivered on this promise by signing into law the municipal ID program and tasking the Mayor’s Office of Immigrant Affairs to take the lead in crafting the program.

IDNYC has several features that benefit immigrant communities, which has led to more than one million New Yorkers obtaining the card. First and foremost, immigration status is not a barrier to obtaining an IDNYC. To apply for IDNYC, New Yorkers age 14 and up must prove identity and residency in New York City. To establish identity and meet eligibility criteria, a variety of documents including foreign and domestic passports, driver’s licenses, and a range of other ID documents can be used, often in combination (NYC Human Resources Administration/IDNYC 2017). Second, on the back of an IDNYC, each cardholder can designate their preferred language. This is valuable not only because the city of New York recognizes its residents speak over 200 languages, but also because awareness of an individual’s preferred language has important applications in emergency situations. Third, IDNYC’s comprehensive security protections mean that an applicant’s personal information is safe. The city respects and takes seriously that confidentiality is a major concern for New Yorkers across all backgrounds. These three features play an important role in the overwhelming demand for IDNYC since its launch in January 2015 -- by March 2017, IDNYC had more than one million cardholders. Today, roughly one in 10 eligible residents is connected to her fellow New Yorker through this common signifier of belonging.

To better understand the cardholder experience, in August 2016, the city commissioned an independent, comprehensive evaluation to obtain a better understanding of how the program was working with cardholders in the year and a half since launch. The study analyzed survey response data from more than 70,000 cardholders, as well as from focus groups and interviews (Bergman et al 2016, i). In the evaluation, 77 percent of immigrant survey respondents said that they felt a stronger connection with New York City thanks to their IDNYC (Bergman et al 2016, ii). 52 percent of respondents reported that they used IDNYC as their primary form of identification. Critically, nearly a quarter of immigrant respondents noted that it was their only form of U.S. photo ID. This data validated the city’s approach in making a municipal ID accessible and responsive to the diversity of communities we serve.

Immigrant advocate groups and community-based organizations rooted in immigrant communities have been integral to IDNYC’s success. In addition to IDNYC’s many permanent enrollment centers throughout the five boroughs and IDNYC’s mobile enrollment center, IDNYC operates temporary “pop-up” enrollment sites. Many advocacy and service-based organizations have hosted a pop-up site, in which IDNYC staff set-up the equipment to process applications at a venue, as they would at a permanent site, and operate out of the venue typically from one to two weeks. This brings IDNYC even closer to the community so that organizations can more easily promote IDNYC and bring their staff, volunteers, and community members to sign up for the card. These pop-ups are also important opportunities to forge deeper partnerships and share information on City services with senior centers and shelters, among other organizations. Innovative collaborations for service delivery are a core piece of the city’s approach to ensuring that immigrant communities are plugged into New York.

While the IDNYC program has had many successes, the program also faced challenges in its early days including responding to initial overwhelming demand and coordinating with banks to recognize IDNYC as a valid form of identification to open an account. The city estimated that approximately 100,000 people would have IDNYC after the first year. However, 50,000 people applied for IDNYC in the program’s first week alone, and by the end of the first year, more than 670,000 New Yorkers had IDNYC. This demand reflects the broad support IDNYC has across NYC’s communities, resonating with many New Yorkers. The city was able to manage this demand through programmatic changes and by working across agencies to increase enrollment capacity. On its third day of operation, responding to high demand, IDNYC switched from walk-in enrollment to an appointment-based system (NYC Mayor’s Office 2015). Shortly thereafter, the city was able to expand enrollment sites at City agencies and public buildings, such as at the Department of Health and Mental Hygiene and LaGuardia Community College, as well as pop-up enrollment sites across the city. These measures allowed the city to meet demand swiftly and improve the enrollment experience.

The city has been able to form meaningful partnerships across sister agencies and with private and nonprofit partners to offer a myriad of popular benefits to cardholders. The city has worked to make the card highly functional across many agencies. New Yorkers can use their IDNYC as their library card for all three City library systems, to look up their children’s vaccination records with the Department of Health and Mental Hygiene, and as valid ID recognized in interactions with the New York City Police Department. Beyond our work with City agencies, IDNYC’s partnerships have enabled New Yorkers to open bank accounts, realize savings, and enjoy some of the city’s most celebrated cultural touchstones. With participating banks and credit unions, IDNYC can be used as a primary or secondary form of ID to open a bank account, critical to many New Yorkers who would otherwise have difficulty accessing traditional banking. Since the beginning of the program, cardholders have saved more than $908,000 on groceries through partnering with Food Bazaar, as well as more than $569,000 on generic prescription drugs through the city’s prescription drug discount plan, Big Apple Rx (Banks et al 2017, 7). IDNYC cardholders can receive free and discount memberships at more than 40 cultural institutions across the city, including the American Museum of Natural History and the Metropolitan Museum of Art. More than 500,000 New Yorkers have redeemed cultural benefits to date. These partnerships have made tangible, measurable impacts in New Yorkers’ lives and have helped make IDNYC as popular as it is.

Interagency Work and Language Access

Much like with IDNYC, our sister agencies play an extremely important role in making New York a city for all New Yorkers. In a city of more than 8.5 million people -- with nearly 300,000 City and other public employees (Goodman 2017) -- the Mayor’s Office of Immigrant Affairs advises fellow City agencies on best practices to make services more inclusive of immigrants. This year, for example, the Mayor’s Office of Immigrant Affairs worked with the NYC Department of Education to issue updated protocol on access to schools for non-local law enforcement, including federal immigration agents (NYC Mayor’s Office 2017). Under this protocol, non-local law enforcement will not be permitted to enter public schools, except when absolutely required by law. Similarly, information will only be shared when required by law. This guidance has been important in demonstrating to many New York City school families that the city is seriously responding to their concerns. By working with City agencies, the Mayor’s Office of Immigrant Affairs can leverage its role as chief advocate for immigrant New Yorkers to make the city even more inclusive.

The Mayor’s Office of Immigrant Affairs builds on this approach by advancing language rights in New York City and serving as a language bridge to our city’s residents. Nearly half of New Yorkers speak at least one language other than English at home, and almost a quarter of New Yorkers have limited English proficiency. Since the Mayor’s Office of Immigrant Affairs was established in 2003, our office has worked to strengthen language rights. The Office facilitates interpretation and translation services for the Mayor’s Office, such as at town halls in which the Mayor meets directly with community members, and we advise our sister agencies on how to bolster their internal commitments to language access. This year, our office worked with the City Council on Local Law 30, the city’s new language access law requiring agencies that provide direct services to the public to make their most popular documents available to New Yorkers in the city’s ten most spoken languages, including the six that were previously required via executive order -- Spanish, Chinese, Russian, Haitian Creole, Korean, and Bengali -- as well as four additional languages -- Arabic, Urdu, French, and Polish (NYC Mayor’s Office of Immigrant Affairs 2017). The Office is helping to implement the new law in a variety of ways, including closer work with agency language access coordinators. The de Blasio Administration has also increased local investments: contracted language services expenditures have increased from 13.8 million dollars in FY2014 to 21.2 million dollars in FY2016 (Agarwal 2016). Multiple agencies have increased their bilingual and multilingual staff, such as the New York City Commission on Human Rights. Protecting and advancing language rights in New York helps city residents get the information they need to take advantage of their rights and opportunities.

Workers’ Justice

Mayor de Blasio’s Administration has not only worked to make City agencies more inclusive and responsive to needs of immigrant communities, but has also launched many new initiatives to strengthen workers’ rights and immigrant working families. Universal Pre-K and guaranteed paid sick leave have been major boons to advancing workers’ rights, including immigrant workers (NYC Mayor’s Office 2014). In partnership with the NYC City Council, in 2014, the first bill Mayor de Blasio signed into law guaranteed paid sick leave for an additional 500,000 New York City workers. Through the Department of Consumer Affairs’ enforcement of the paid sick leave law, two years after its enactment, nearly 9,600 workers received restitution under the law, and the city received 1.7 million dollars in fines. Mayor de Blasio’s championing of high-quality childcare has been important for working families of all backgrounds, including immigrant families. The Mayor made universal Pre-K a reality in New York for the approximately 70,000 eligible four-year-olds in the city (NYC Mayor’s Office 2014); families with students enrolled in the universal Pre-K program now save on average $10,000 a year on childcare (NYC Mayor’s Office 2016). As with our K-12 schools, the universal Pre-K program in New York City is available to all students, regardless of immigration status. These initiatives have made New York City a more sustainable home for immigrant working families.

With the leadership of the de Blasio administration, including the Department of Consumer Affairs, New York City has been at the forefront of safeguarding immigrant workers’ rights. A major advancement in this effort was the establishment of the Office of Labor and Policy Standards (OLPS) within the Department of Consumer Affairs, to serve as the city’s permanent voice for New York City’s workers (NYC Mayor’s Office 2016). The Mayor’s Office of Immigrant Affairs has worked closely with OLPS to advance immigrant workers’ rights -- in April 2017, our Office, OLPS, and the New York City Commission on Human Rights held a public hearing on the state of workers’ rights in the city -- hearing directly from workers, particularly many immigrant workers, about challenges they have faced (NYC Department of Consumer Affairs 2017). The Office of Labor and Policy Standards enforces many local labor laws, including the city’s new Fair Workweek laws, which enshrine predictable schedules and paychecks as a right in the fast food and retail industries (NYC Mayor’s Office 2017). This will significantly benefit immigrant families -- while immigrant New Yorkers make up approximately 46 percent of the city’s workforce, they play a large role in the retail industry, as 48 percent of first-line supervisors of retail workers and 56 percent of cashiers (Rivera and Hamaji 2016, 8). Under the de Blasio Administration, New York City will continue to lead the way to protect and advance the rights of immigrant workers.

City Immigration Legal Services Programs

New York City has a wide variety of immigration legal service programs that allow the city to work with existing community-based providers with deep ties to the residents they serve. Legal status plays a complex and important role in the lives of many New Yorkers. About half of all immigrant New Yorkers are naturalized citizens, approximately 1.6 million people in total. Another 650,000 New Yorkers are legal permanent residents who are eligible to naturalize and become U.S. citizens (Enchautegui and Giannarelli 2015, 10). In addition, about 500,000 New Yorkers are undocumented, including more than 30,000 recipients of the Deferred Action for Childhood Arrival program, or DACA (American Community Service 2015). This wide range of immigration statuses in New York City requires that City services, such as immigration legal services, limits the degree to which immigration status is a barrier, so that as many people as possible have access to resources they need to thrive. By partnering with providers New Yorkers already know and trust, we can reach more people, more efficiently. Many immigrants are interested to learn how they can apply for citizenship or certain visa programs, but are unsure of the procedures or lack the funding to seek legal help. This is where the city has stepped in to remove barriers to access to justice for immigrant New Yorkers with two signature legal programs, NYCitizenship and ActionNYC

NYCitizenship provides no-cost and secure legal help and financial counseling for immigrants interested in applying for naturalization. While an estimated 650,000 New Yorkers are eligible to apply for citizenship, some find the process daunting and unaffordable. NYCitizenship works to bridge that gap, enabling more immigrants and their communities to enjoy the many benefits that come with citizenship. Through the program, New Yorkers can make an appointment to receive a free screening at a participating public library to help answer questions related to applying for citizenship, including fee waivers. All clients are also referred to free, confidential financial counseling services. Citizenship status bestows meaningful benefits for immigrants and their communities. Citizenship is positively correlated with increased pay, greater levels of home ownership and more civic participation. On average, immigrants who naturalize realize an increase in annual earnings of 8.9 percent (American Community Service 2015). Private philanthropy has played a major role in supporting NYCitizenship, helping the program reach 1.6 million dollars in funding for its second year (NYC Mayor’s Office 2017), a demonstration of how the city and the Mayor’s Office of Immigrant Affairs can leverage its role as a convener and advocate to increase immigrants’ access to services.

While NYCitizenship specifically targets naturalization, ActionNYC provides free and safe immigration legal help on a wide range of immigration issues for New Yorkers. In order to reach as many people as possible, the city encourages New Yorkers with immigration legal questions to schedule an appointment with ActionNYC, the city’s premier program providing immigration legal services to New Yorkers. Through ActionNYC, New Yorkers can receive a free legal screening in the languages they speak from community navigators at trusted locations, like local community-based organizations, schools, and hospitals. From there, attorneys and community navigators work to determine which clients they will represent through the program and which will be referred to other City-funded, free legal service providers, among other legal services. In the process of receiving a legal screening, ActionNYC can also connect its clients to other public programs that they are eligible for, like IDNYC or Medicaid. In the year and a half that ActionNYC has been in operation, the program has served thousands. Helping immigrants receive a qualified legal screening, more secure immigration status and bringing City services closer to the people we serve is not only a great economic empowerment tool, it increases accessibility and visibility for services like Medicaid that can meaningfully improve an individual’s quality of life.

ActionNYC’s ability to deliver immigration services across the city is a result of working with a variety of partners in creative ways. Mayor de Blasio announced the creation of the program in December 2015, starting with a 7.9-million-dollar investment from the city (NYC Mayor’s Office 2015). Through ActionNYC, the city contracts with partners throughout the five boroughs to achieve the three goals at the heart of the ActionNYC model: community navigation, legal services, and outreach. Permanent navigation sites within community-based organizations situated in immigrant-dense neighborhoods have allowed ActionNYC to be accessible to the thousands of clients it has already served. With a combination of attorneys and community navigators, the navigation sites efficiently provide legal screenings, deliver legal services (such as application assistance and legal representation), and assist in referrals for complex cases. In order to reach immigrants who have been most in need of free and confidential immigration legal services, ActionNYC initially relied on a robust outreach and marketing program (NYC Mayor’s Office of Immigrant Affairs 2016, 6). From City-supported community outreach groups canvassing neighborhoods and conducting community presentations, to transit ad campaigns, community and ethnic media roundtables, websites, and creative social media content (NYC Mayor’s Office of Immigrant Affairs 2016, 12-15), ActionNYC’s outreach has connected with New Yorkers in need of services in inventive ways.

ActionNYC’s navigation model is designed to bring immigrant voices to the forefront. ActionNYC partners with immigrant advocacy groups across the city to conduct culturally competent advising in immigrant communities. Community navigators at these sites are reflective of their community and take the lead in connecting community members with legal help and other City services in the languages they speak. ActionNYC community navigators also receive training, ongoing supervision, and continued support to become accredited representatives of the U.S. Department of Justice’s Office of Legal Access Programs. As accredited representatives, they can provide legal advice thereby increasing the city’s capacity to provide immigration legal services. This model has the additional benefit of focusing trained attorneys on complex cases that require representation. ActionNYC continues to find new ways to improve providing services to residents, including placing sites in locations New Yorkers already live, learn, work and play. In partnership with the NYC Department of Education, our ActionNYC in Schools initiative has held more than 80 immigration legal clinics at approximately 30 targeted schools. By using schools to host legal clinics and navigation sites, ActionNYC can partner with trusted institutions to provide convenient immigration legal services in places that New Yorkers already trust.

Alongside partnerships with City agencies, through ActionNYC, the Mayor’s Office of Immigrant Affairs is committed to helping build capacity with trusted community partners with deep ties to the city’s newer immigrant populations, particularly from the Caribbean, Asia and Africa. To that end, in summer 2017, ActionNYC is holding a fellowship program for 17 community-based organization partners to provide organizing and legal training, as well as technical assistance, to assist community-based organizations in their work with ActionNYC, and to build their internal capacity (NYC Mayor’s Office of Immigrant Affairs 2017). These programs highlight how seriously the city takes its mission to reach immigrant New Yorkers at every level through innovative partnerships with fellow City agencies and community organizations, and support those community partners in the important work they already do in their neighborhoods.

The need for immigration legal services spiked following the presidential election in 2016. In the first three months of the Trump administration, U.S. Immigration and Customs Enforcement arrested nearly 40 percent more immigrants nationwide than in the same period the previous year (Sacchetti 2017). From January to February 2017, calls to ActionNYC’s hotline increased by 140 percent compared to the same period the previous year. In response, in April 2017, Mayor de Blasio announced a major increase for New York City’s provisioning of immigration legal services. New York City has invested an additional 16.4 million dollars for immigration legal services (NYC Mayor’s Office 2017), bringing the Mayor’s investment to more than 31 million dollars for immigration legal services, an unprecedented investment at the local level. Our office is also dramatically expanding our work providing Know Your Rights Forums in immigrant communities. This investment is responsive to the fact that many immigrants lack access to attorneys -- particularly those with complex cases -- as people are not guaranteed access to representation in federal immigration court. From NYCitizenship, to ActionNYC and the additional funding for immigration legal services this year, New York City continues to seek innovative ways to address the need for access to justice for immigrant New Yorkers, particularly under the new federal administration.

Unaccompanied Migrant Children

Under the leadership of Mayor de Blasio, New York City was able to responsibly and compassionately welcome an unprecedented influx of unaccompanied migrant children. Migrant children crossing the border steadily increased in the early 2010s before reaching crisis levels in 2014 (Rosenblum 2015, 2). While New York City traditionally does not have a large refugee population (roughly 8,000 refugees were originally settled in New York City in the last 15 years) (American Community Survey, 2017), more than 2,000 migrant children were placed in New York City, the second highest placement in the country. Recognizing that addressing the needs, including placement, of this exceedingly vulnerable immigrant population would take a collaborative approach, the Commissioner of the Mayor’s Office of Immigrant Affairs under Mayor de Blasio, Nisha Agarwal, led the city’s interagency task force to craft best practices for addressing the issue. One major task force recommendation was the unprecedented decision to place City representatives directly in Immigration Court in September 2014 (NYC Mayor’s Office 2014). As one example, representatives from the Department of Education and the Department of Health and Mental Hygiene were stationed at the courts to help migrant children enroll in school and health insurance. Creative problem-solving and interagency partnerships, rather than an increase in the city’s budget, were key to figuring out how best to facilitate access to services.

While the city provided the impetus to address the unaccompanied migrant crisis in New York through City agency collaboration and bringing services closer to migrant children, philanthropic groups played a critical role in providing migrant children with legal representation. The Robin Hood Foundation and the New York Community Trust, two New York City-based charitable organizations, collaborated with the City Council in creating the Immigrant Children Advocates’ Relief Effort (ICARE), an initiative to provide legal representation to migrant children (New York City Council 2016). In the 2017 fiscal year, the Council provided 1.5 million dollars to ICARE and the Robin Hood Foundation and the New York Community Trust contributed 1.1 million dollars. Through ICARE, more than 1,000 cases involving migrant children received representation, showing how government and philanthropy together can help protect children.

This kind of resourcefulness, along with close coordination with other City agencies and local organizations, demonstrates how cities can take an innovative approach to solve problems when they make the commitment to invest in immigrant communities and leverage partnerships with City agencies, philanthropy, and service providers.

Cities for Action

As the ultimate city of immigrants, NYC is an important leader in the national conversation around immigration policy. Local leaders have a unique perspective based on their on-the-ground work with immigrant families. Collaboration among mayors around the country has proven impactful in enabling American cities to advocate on a national level for their residents’ needs. In December 2014, in tandem with President Obama’s announcement of executive action, 20 mayors from across the country gathered in New York City to discuss how best to implement the President’s expansion of DACA and creation of the Deferred Action for Parents of Americans and Lawful Permanent Residents program, or DAPA (NYC Mayor’s Office 2014). This meeting grew into Cities for Action, a national coalition of more than 150 mayors and municipal leaders from across the country working together to advocate for and support immigrants, through support for a humane federal immigration overhaul and measures to protect immigrant residents (Cities for Action 2017). The coalition worked together to file an amicus brief in support of the Obama administration’s actions to expand DACA and establish DAPA in U.S. v. Texas. In total, 118 mayors and county leaders signed on to the Cities for Action amicus brief, representing 55 million people (Cities for Action 2016). Cities for Action harnesses the power that cities have when working collectively to tackle one of the nation’s most intractable issues.

More recently, Cities for Action has taken several steps to support immigrant communities under the Trump administration. Cities for Action coordinated on five legal briefs in response to President Trump’s executive orders. Three amicus briefs were in support of plaintiffs challenging the Administration’s travel ban: Darweesh v. Trump in the Eastern District of New York, legal briefs submitted to the Fourth Circuit and Ninth Circuit, and two lawsuits challenging the Administration’s “sanctuary city” executive order in Santa Clara County v. Trump and City and County of San Francisco v. Trump. In addition, more than a dozen mayors and county leaders signed on to a Cities for Action letter to the U.S. Department of Homeland Security (DHS) and the U.S. Department of State calling for a full 18-month extension of Temporary Protected Status (TPS) for Haiti, which impacts 50,000 Haitian nationals settled in the U.S. following the devastation of the 2010 earthquake (Walsh et al 2017). Shortly after, DHS Secretary Kelly announced a six-month extension of Temporary Protection Status (TPS) for Haiti (DHS Office of the Press Secretary 2017). The Mayor’s Office of Immigrant Affairs will continue our work to advocate for a full extension of TPS through vocal advocacy with cities across the country as well as by actively working with the Mayor’s Community Affairs Unit, community partners, legal providers, and faith leaders to provide information to Haitian communities and connect them to legal services. Even in this challenging environment for immigration, Cities for Action is addressing real policy issues for immigrants across the country, and mayors and county leaders will continue to lead on smart immigration policy despite gridlock in Washington.

Conclusion

Many studies show that immigrants strengthen city economies and create jobs, and that is exactly what immigrants and the children of immigrants have done in New York City. As the biggest city in the country, and one that is deeply in touch with our immigrant heritage, the city of New York goes beyond thinking only about what immigrants can do for the city, but instead how we can shape the city to be more inclusive of immigrant communities. We do this by engaging with our residents and stakeholders in innovative ways to reach our vision: a city where immigrants are empowered as civic actors and deeply integrated in all facets of city life. With the largest Mayor’s Office of Immigrant Affairs in the nation, we use our position to come up with new ways to bring immigrant perspectives in city government to create world-class programming like IDNYC and ActionNYC to support and strengthen immigrant New Yorkers. Working together with our partners in other cities, we will continue to share what works in NYC, incorporate what works in other cities and strive to improve our cities as open and welcoming places for all.

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